Provider Demographics
NPI:1124503784
Name:NGAN, WAI FUNG
Entity type:Individual
Prefix:
First Name:WAI FUNG
Middle Name:
Last Name:NGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8757 17TH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4546
Mailing Address - Country:US
Mailing Address - Phone:646-925-8884
Mailing Address - Fax:
Practice Address - Street 1:7216 ROOSEVELT AVE # 2R
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6335
Practice Address - Country:US
Practice Address - Phone:347-808-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006085171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist